The Joint United Nations Programme on HIV/AIDS (UNAIDS)
delivered some rare good news about the epidemic this week. In a report released on Tuesday, the international agency trumpeted
a global decline in both new infections and deaths from infection.
The welcome finding is yet more proof that we are capable of defeating this epidemic when we invest meaningfully
in the fight. And it is a sobering reminder that our failure to do so here in the United States has produced the opposite
result: more infections, more death and a continuingly worsening Black epidemic.
The UNAIDS report describes a slight, but steady decrease in new infections each year since 2001. In 2001,
there were three million new infections; last year, there were 2.7 million. And in sub-Saharan Africa, which accounts for
two-thirds of the global epidemic, HIV prevalence has either stabilized or declined in most countries over the last decade.
These declines are driven, according to UNAIDS, by massive and successful prevention campaigns in those countries. The agency
cites as examples several sub-Saharan African countries where prevention campaigns have spawned increased condom usage among
sexually active young people.
The UNAIDS report also notes that the percentage of people worldwide who are living with HIV/AIDS has leveled
off since 2000, though the overall number continues to grow. An estimated 33 million people are living with HIV/AIDS today.
New infections among children in particular have dropped significantly in recent years as HIV-positive pregnant
women have gained widespread access to antiretroviral drugs that stop mother-to-child transmission. Between 2005 and 2007,
the percentage of positive pregnant women getting antiretrovirals more than doubled, to 33 percent. Several countries boast
nearly universal access to meds for pregnant women.
Meanwhile, rapidly expanding access to treatment worldwide has driven down death rates as well, UNAIDS says.
An estimated 3 million people are now getting antiretroviral treatment in poor and developing nations; that's an increase
of more than three fold since 2004. As a result, deaths dropped for the first time in 2006 and have continued to fall. They
fell from 2.2 million deaths in 2006 to 2 million in 2007. Though, notably, AIDS remains the leading cause of death in sub-Saharan
Africa.
All of these advancements come as President Bush prepares to sign into law an expansion of his administration's
global AIDS initiative. The program, which among other things directly funds treatment for people in 15 hard-hit countries,
has been celebrated as a foreign policy success and an historic global health commitment. It's just this sort of effort that
has helped drive the victories UNAIDS reported this week.
But a Black AIDS Institute report, "Left Behind! Black America: A Neglected Priority in the Global AIDS Epidemic", describes how the U.S. has failed to make a similar commitment to fighting the epidemic raging here at home.
Black America has an HIV prevalence of 2 percent; only four countries outside of sub-Saharan Africa have comparable
rates. The overall number of Blacks living with HIV is greater than that of seven of the 15 countries targeted in the president's
initiative. Given these and other facts, Black America would undoubtedly be a priority for the U.S. global AIDS initiative-if
only it weren't inside the U.S. Instead, the federal AIDS budget for both treatment and prevention has remained flat or, in
some cases, declined since 2001. During that time, as many as 30,000 Black Americans were newly infected every year.
The UNAIDS report shows us clearly that AIDS can be stopped. There remains much work to be done globally,
but we have come together as a global community determined to end the epidemic in poor and developing nations. We are seeing
the results of that commitment. On the other hand, we have refused to make a similar commitment at home, and we are also seeing
the results of that failure. It's high time the U.S. follows its own example-and ends this epidemic at home and abroad.
